Duodenal Ulcer

Was this helpful?
31

What is a duodenal ulcer?

A duodenal ulcer is a type of peptic ulcer that occurs in the duodenum, the beginning of the small intestine. Peptic ulcers are eroded areas in the lining of stomach and duodenum, which result in abdominal pain, possible bleeding, and other gastrointestinal symptoms. The most common cause of duodenal ulcer is a stomach infection associated with the Helicobacter pylori ( H pylori) bacteria.

Other risk factors for duodenal ulcers include overuse of alcohol, tobacco, and medications such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Severe illness has also been implicated as a risk factor in the development of duodenal ulcer.

The signs and symptoms of duodenal ulcer can be constant or sporadic, and the disease course varies among individuals. If H pylori is the cause of the ulcer, the symptoms will remain as long as the infection is untreated. Some people with duodenal ulcers have no symptoms at all, while others may have burning pain, severe nausea, and vomiting.

In the case of H pylori-related duodenal ulcer, the infection can be treated successfully with antibiotics. For a duodenal ulcer not related to H pylori, antacids or other medications are an effective treatment. You can reduce your risk of H pylori infection by following commonsense hygiene practices such as washing your hands with soap and water prior to preparing food and after handling dirty diapers or using the bathroom.

Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms such as severe abdominal pain, bloody or black tarry stools, or bloody or black vomit.

Seek prompt medical care if you are being treated for duodenal ulcer and mild symptoms recur or are persistent.

What are the symptoms of a duodenal ulcer?

Duodenal ulcer causes inflammation and damage to the stomach lining that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of a duodenal ulcer

You may experience duodenal ulcer symptoms daily or just once in a while. At times any of these abdominal symptoms can be severe:

Serious symptoms that might indicate a life-threatening condition

In some cases, duodenal ulcers can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bloody stool (blood may be red, black, or tarry in texture)
  • Severe abdominal pain
  • Vomiting blood
  • What causes a duodenal ulcer?

The most common cause of duodenal ulcer is infection with H pylori bacteria. Other causes of duodenal ulcer include agents that can cause inflammation of the stomach or duodenal lining, including alcohol, tobacco, or medications such as nonsteroidal anti-inflammatory drugs (NSAIDs). Severe illness and radiation therapy have also been associated with duodenal ulcer.

What are the risk factors for a duodenal ulcer?

A number of factors increase the risk of developing duodenal ulcer. Not all people with risk factors will get duodenal ulcer. Risk factors for duodenal ulcer include:

  • Alcohol abuse

  • H pylori infection

  • History of radiation therapy

  • Regularly taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin

  • Stress or severe illness

  • Tobacco use

How is a duodenal ulcer treated?

Treatment for duodenal ulcer begins with seeking medical care from your health care provider. To determine if you have a duodenal ulcer, your health care provider may ask you to undergo diagnostic tests.

Antibiotic treatments for a duodenal ulcer

If your duodenal ulcer is caused by H pylori infection, antibiotic therapy is the mainstay of treatment. It is important to follow your antibiotic regimen precisely to avoid re-infection or recurrence. Most commonly, two antibiotics are given for 14 days. Examples of antibiotic treatments include:

  • Amoxicillin
  • Clarithromycin (Biaxin)
  • Metronidazole (Flagyl)
  • Tetracycline

Other medications to treat a duodenal ulcer

Medications such as proton pump inhibitors and histamine H2-receptor antagonists, which decrease the amount of acid in the stomach, can also be an effective treatment for duodenal ulcer.

Proton pump inhibitors that are effective in the treatment of duodenal ulcer include:

  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)

Histamine H2-receptor antagonists that are effective in the treatment of duodenal ulcer include:

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What are the potential complications of a duodenal ulcer?

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Possible complications of duodenal ulcer include:

  • Internal hemorrhaging
  • Perforated duodenal ulcer, which can lead to bleeding
  • Severe discomfort or pain
  • Spread of infection

How is a duodenal ulcer treated?

Treatment for duodenal ulcer begins with seeking medical care from your health care provider. To determine if you have a duodenal ulcer, your health care provider may ask you to undergo diagnostic tests.

Antibiotic treatments for a duodenal ulcer

If your duodenal ulcer is caused by H pylori infection, antibiotic therapy is the mainstay of treatment. It is important to follow your antibiotic regimen precisely to avoid re-infection or recurrence. Most commonly, two antibiotics are given for 14 days. Examples of antibiotic treatments include:

  • Amoxicillin
  • Clarithromycin (Biaxin)
  • Metronidazole (Flagyl)
  • Tetracycline

Other medications to treat a duodenal ulcer

Medications such as proton pump inhibitors and histamine H2-receptor antagonists, which decrease the amount of acid in the stomach, can also be an effective treatment for duodenal ulcer.

Proton pump inhibitors that are effective in the treatment of duodenal ulcer include:

  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)

Histamine H2-receptor antagonists that are effective in the treatment of duodenal ulcer include:

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What are the potential complications of a duodenal ulcer?

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Possible complications of duodenal ulcer include:

  • Internal hemorrhaging
  • Perforated duodenal ulcer, which can lead to bleeding
  • Severe discomfort or pain
  • Spread of infection
Was this helpful?
31
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 2
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Peptic ulcer. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001255/
  2. Helicobacter pylori and Peptic Ulcer Disease. Centers for Disease Control and Prevention. http://www.cdc.gov/ulcer/